Evidence map›Paper›PMID 29862380›Full record

ArticlePediatric quality & safety2016

Potential Acetaminophen and Opioid Overdoses in Young Children Prescribed Combination Acetaminophen/Opioid Preparations.

William T Basco, Sandra S Garner, Myla Ebeling, Thomas C Hulsey, Kit Simpson

Open access · diamondAbstract read
In one paragraph

Article in Pediatric quality & safety, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.5field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

William T BascoDepartment of Pediatrics, College of Medicine, The Medical University of South Carolina, Charleston, S.C.; Department of Clinical Pharmacy and Outcome Sciences, South Carolina College of Pharmacy, Charleston, S.C.; Department of Epidemiology, West Virginia University, Morgantown, W.Va.; and Department of Health Administration and Policy, College of Health Professions, The Medical University of South Carolina, Charleston, S.C.
Sandra S GarnerDepartment of Pediatrics, College of Medicine, The Medical University of South Carolina, Charleston, S.C.; Department of Clinical Pharmacy and Outcome Sciences, South Carolina College of Pharmacy, Charleston, S.C.; Department of Epidemiology, West Virginia University, Morgantown, W.Va.; and Department of Health Administration and Policy, College of Health Professions, The Medical University of South Carolina, Charleston, S.C.
Myla EbelingDepartment of Pediatrics, College of Medicine, The Medical University of South Carolina, Charleston, S.C.; Department of Clinical Pharmacy and Outcome Sciences, South Carolina College of Pharmacy, Charleston, S.C.; Department of Epidemiology, West Virginia University, Morgantown, W.Va.; and Department of Health Administration and Policy, College of Health Professions, The Medical University of South Carolina, Charleston, S.C.
Thomas C HulseyDepartment of Pediatrics, College of Medicine, The Medical University of South Carolina, Charleston, S.C.; Department of Clinical Pharmacy and Outcome Sciences, South Carolina College of Pharmacy, Charleston, S.C.; Department of Epidemiology, West Virginia University, Morgantown, W.Va.; and Department of Health Administration and Policy, College of Health Professions, The Medical University of South Carolina, Charleston, S.C.
Kit SimpsonDepartment of Pediatrics, College of Medicine, The Medical University of South Carolina, Charleston, S.C.; Department of Clinical Pharmacy and Outcome Sciences, South Carolina College of Pharmacy, Charleston, S.C.; Department of Epidemiology, West Virginia University, Morgantown, W.Va.; and Department of Health Administration and Policy, College of Health Professions, The Medical University of South Carolina, Charleston, S.C.
Medical University of South Carolina · US

Funding

SOUTH CAROLINA CLINICAL & TRANSLATIONAL RESEARCH INSTITUTE (SCTR)UL1RR029882 · NCRR · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI BRADY, KATHLEEN T. · 2009 to 2011
$10.1M
South Carolina Clinical & Translational Research Institute (SCTR)UL1TR000062 · NCATS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI BRADY, KATHLEEN T. · 2012 to 2014
$9.4M
Prescribing Errors in Ambulatory Pediatric CareK08HS015679 · AHRQ · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI BASCO, WILLIAM T · 2006 to 2009
$508k
AHRQ HHS K08 HS015679NCATS NIH HHS UL1 TR000062NCRR NIH HHS UL1 RR029882
6 · The paper itself

Abstract

introductionCombination preparations of acetaminophen/opioid are the most common opioid form prescribed to children. We tested the hypothesis that dispensed prescriptions of acetaminophen/opioid preparations more appropriately match acetaminophen dosing parameters than opioid dosing parameters. We also hypothesized that the frequency of potential overdose was inversely related to subject age.

methodsUsing 2011 to 2012 South Carolina outpatient Medicaid data, the authors identified acetaminophen/opioid preparations dispensed to children 0 to 36 months. Utilizing Centers for Disease Control and Prevention (CDC) data to impute subject weights as the 97th percentile for age and gender, the authors used imputed weights to calculate the maximum recommended daily dose (expected dose) of each component. We calculated the dose delivered per day (observed dose) based on drug concentration, volume dispensed, and days' supply and then calculated the frequency of overdose (observed dose/expected dose, >1.10) by each component, comparing overdose frequency of acetaminophen to the overdose frequency of opioid using a risk ratio. Logistic regression evaluated differences in potential overdose by age, controlling for race/ethnicity and gender.

resultsAmong 2,653 dispensed prescriptions of study drugs to 2,308 children 0 to 36 months old, the frequency of potential overdose was 0.7% for acetaminophen and 1.6% for opioid (risk ratio, 2.28). Age less than 3 months was associated with a greater frequency of potential overdose of either acetaminophen or opioid, even after controlling for gender and race/ethnicity.

conclusionsPrescriptions of acetaminophen-opioid drugs dispensed to children 0 to 36 months old contained potential overdoses of opioid at greater than twice the frequency of acetaminophen and were more likely to occur in infants less than 3 months old.

Indexed as

Childchildrenmedication errorsoverdosepatient safety

Identifiers

PMID29862380
PMCPMC5965365
OpenAlexW2953326988

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.